How to Save Money on Prescriptions (And Have a Better Outcome)

 

Let’s talk about prescriptions. A lot of people need prescriptions pretty regularly. I mean a serious amount. The CDC (Center for Disease Control) estimates that about 50% of Americans have used a medication in the past 30 days alone. That’s a seriously significant chunk of people that visit the pharmacy. So let’s think about how many of us shop around for our prescriptions. I’m going to guess a very very slim margin are going to give any thought to looking at pricing before filling the prescription at the pharmacy.

Let me guess: You go to your doctor’s office, and they prescribe you a medication. You then take it to your usual pharmacy and they fill it for you at whatever price they want. Sound like you? What if I told you that there was a way to do it differently.

Here are a few things to consider before you get your prescription filled:

  • The same prescription at one pharmacy will likely cost something different at another
  • Your insurance company might prefer (pay a larger %) for certain formularies, usually generic brands
  • Your medications may negatively interact with one another

With the above information in mind, its important to consider that there are 2 main factors to be concerned about: the effectiveness and the cost of your medication.

Looking firstly at effectiveness, we want to make sure that whatever medication you have been prescribed is actually working. You should talk to your pharmacist and make sure that none of your medications are canceling each other out, or having adverse side effects. You can also use this online tool to see if there are any issues. You shouldn’t expect your doctor to have done that homework for you, so its best to ask the people that have really been trained in that area.

Let’s next move on to cost. I’m going to guess that you do a bit of research before you buy most things, why not do the same with your prescriptions? Using a price comparison tool like Goodrx is no more challenging than checking the price of a blender on Amazon before you buy it locally.

Whether you’ve noticed it or not, prescription prices have risen dramatically in recent years. In the last year alone, average prices have risen 10%, and that includes generics. And its been that way for the last 3 years in a row. While it may not be huge change for a one-off prescription, its going to add up dramatically over time. Especially when you consider the cost for a family of 4 or 5.

It gets even more serious for people that are a bit older, where the amount of prescriptions average 4.5 per month, the increasingly extortionate prices are having serious consequences. AARP estimated that the median cost of some of the most widely used chronic medications run at $5,800 per year. That’s a huge opportunity for savings if you just shop around a bit.

I’ve included Trig’s list of things that you should do when getting a medication below. Check it out for a more comprehensive list of steps.

 

  1. Make sure you talk to your doctor to understand why you are taking a new medication and what the side effects may be.
  2. Check your formulary to see which medications are preferred by your health insurance company. Your health insurance company may require prior authorization.
  3. Check the price of the medication by comparing the cost at the pharmacies in your area.
  4. Make sure your pharmacist is aware of all medications you are taking to make sure they are compatible with your new medication or run your medications through a drug interaction checker. Verify that it is the correct medication, the correct dosage and that you understand the directions.
  5. If you are on 5 or more prescriptions, you can take advantage of your carrier’s Medication Management Therapy program. Call your insurance carrier’s customer service line to find out more about this helpful program.
  6. Monitor your progress, noting any continuing symptoms and/or reactions to your medication and report any necessary information to your doctor.

 

 

4 Reasons Why You Should Be Using Telehealth

Telemedecine is something that we’re constantly talking about. Not because it’s the end-all be-all of healthcare, or because it can replace your doctor, but because its simply underutilized. Telemedecine can remove a ton of the roadblocks and challenges that people experience that often prevents them from seeing the doctor in a timely manner. Things like having to get time off work, or waiting to get your children in after school are pretty much non-existent.

 

Now, there are a number of ways that the term “telehealth” can be used, because technology has really transformed the way we get healthcare. Here are some of the most common ways that we use “telehealth”. 

  • You can visit with your doctor on your phone or do a video-chat
  • you can interact with medical apps to upload and track things like your weight and diet
  • and you can log on to your doctor’s website to check test results and get reminders to do things like get flu shots

 

Needless to say, the possibilities are extensive. But what we’re really concerned with is the first one, visiting with your doctor on your phone. This is because having the ability to see your doctor from anywhere has been a serious game changer in the industry over the last few years. In 2016, over 1 million people saw their doctor on the phone. That’s pretty astonishing when you think about it. Let’s look at the top reasons why you should be using telehealth this year, especially if you haven’t already.

 

  1. Speed – you can typically get in to see a provider on your phone in a matter of minutes. It is obviously hugely dependent on the company that you use, but you’re likely to get in far faster on the phone than it would take you to drive to the doctors office. To match that, if you’re waiting on results or other information, you’ll be able to view it immediately after it’s been uploaded. No need to wait for a callback or to go in and get the results face-to-face. Almost 40% of telehealth appointments last year were for getting a medication. Simple stuff like this that typically takes a long time can be seriously reduced.
  2. Cost – Here’s a big one, telehealth is significantly less expensive than seeing a provider face-to-face. Think about it, they don’t have to pay for a big fancy clinic to see you in. They could be halfway around the world in their pajamas, but that’s ok. The average cost of a telehealth visit last year totaled $45. That’s pretty cheap. And think about all of the money that you’ll be saving by not having to take time off work or by driving 15 miles to your clinic. The savings start to add up pretty quickly.
  3. Ease – My personal favorite – it’s easy. Once you’ve got your profile all setup on whatever telehealth site you’re using, your doctor will have all of your information on hand. You just have to book your appointment, and turn on your phone when the time comes. If you’re technologically stunted like me, this should be a big plus for you.
  4. Traveler’s Companion – Maybe you travel for work, or maybe you’re on vacation and you’ve gotten sick. Either way, you can still see someone that you’re used to and that knows you. No more looking for clinics in the random part of town that you’ve found yourself in, or figuring out how another country’s healthcare system works.

 

4 Ways the Doctor-Patient Relationship is Changing

It is often said that the relationship between the doctor and the patient is the foundation of the American medical system. Consider your typical Americana small town circa 1950’s. One stoplight on Main  Street, everybody knows everybody, and high school football is the main attraction. You know what I mean. In this scenario, I can tell you exactly who the 3 most important people in town are. The mayor, the priest, and the doctor.  Why? Because these are the people that are the most trusted and are the cornerstone figures in people’s lives.

Let’s leave the analogy there and take a look at the doctors. Do we still place implicit trust in them? Do we still invite them over for casseroles on Sundays? Sort of. In today’s America, we’ve largely diverged from the ask-no-questions mindset. We’ve got the ability to get an instant (self)diagnosis on our phones. We’ve read all about the perils of getting wrong surgeries and being on the wrong medications. While a lot of this has been beneficial for the patient, a lot of it hasn’t. In some cases, it can even be dangerous, as people may be incorrectly self-diagnosing.

Current studies have consistently shown that doctors are more “personable” consistently getting higher ratings from patients. They are, after all, in a “power” position and people want to feel like they are being heard.  Seems pretty fair, right?

It’s not for me to say whether or not the changing doctor-patient landscape is a positive or a negative thing. But I do want to show you a few ways in which it will continue to change:

1.       Patient- doctor relationships will be more important – doctors will be incentivized to receive proper ratings from their patients, otherwise risk receiving financial penalties from Medicare (check that out here).

2.       People are growing more “consumer centric” – a nationwide shift to higher deductible plans has really increased  people’s exposure to possible big bills. With that in mind, the idea is that with increased exposure comes increased consumerism (more on that). Simply put, people are more responsible for making sure that they are getting positive outcomes with their care. As such, we can expect that people will increasingly come to their doctor appointments armed with knowledge (good or bad).

3.       Increased information – we’re not just relying on WebMD anymore. Both public and private institutions are increasing the amount of knowledge that they are putting forth. Expect to see information on a doctor’s payment scheme (who pays them), costs and success rates.

4.       Independent tools and services – outside of seeing your traditional GP, there are a number of services to assist with the “consumerism” aspect of care. Think telehealth, second opinion services and patient literacy training. While most of these are available independently, a lot of them can be purchased for your entire company. With healthcare costs and consumerism rapidly rising, many of these services can offer a compelling case for ROI.

Sure, this isn’t an exhaustive list. But rest assured that the healthcare landscape is definitely changing. And with that comes new responsibilities on behalf of both the patient and the company (who pays for the health plan). Click here for more consumerism and cost containment info.

3 (Free) of the Most Important Preventive Services You Can Get

They say that the best things in life are free. And when it comes to healthcare, that’s no exception. If you haven’t heard, preventive care is free – as in, covered by your insurance. And since we’ve already used one adage, let’s use another: There’s no such thing as a free lunch. Well this time there is. Preventive care really is free, because your insurance company doesn’t want you to get sicker and have extortionately high claims. Makes sense, right? In terms of healthcare, what’s good for your insurance company is often good for you – not being sick. As always, it’s good to check with your insurance company before you get anything done to make sure that everything is within your network and is specifically covered.

With that in mind, we thought it pertinent to look at the most important preventive services that you can get. Even though we’d all love to take advantage of each free service, there’s only so much time in a day, and some services are more important than others. Very important, in fact. If you don’t get these things done, it could cost you much more than the extra cash.

  1. Flu Shot – your immune system isn’t always capable of handling the flu each year. Different flu strains change and you’ve got to get vaccinated for the right one. If you don’t you could be setting yourself up for a few weeks of feeling nasty (yes, stomach stuff). Last year the CDC (center for disease control) estimated that vaccines prevented over 5 million illnesses and over 71,000 hospitalizations. That’s crazy when you consider how much that would cost you, your company, and your insurance provider.
  2. Colonoscopy – this one isn’t so fun. The typical recommendation is that everybody goes in for a colonoscopy at about age 50. And while it’s not fun to prepare for or have a colonoscopy, the results are worthwhile. Colorectal cancer is now the second leading cause of cancer deaths in the US. Prevention and screening is pretty straight forward as well, as it usually takes about 10-15 years for the polyps (the abnormal growth) to turn into cancer.
  3. Mammogram – Unfortunately, we’re up for another screening that isn’t very fun. But mammograms are, simply put, the best way of detecting breast cancer early on. Just checking for lumps isn’t enough according to the American Cancer Society. The society also states that 1 in 8 women will develop breast cancer. Those are scary odds and well worth the checkup.

Even though you may not love dealing with your insurance company, they do offer some pretty nice freebies every now and again. And if you’re less concerned about the money, just think about how much you don’t want to get cancer. The tests are free, go out and get them.

 

 

 

Check out our list below of services made free by the Affordable Care Act:

COVERED SERVICES – FOR MEN AND WOMEN:

Abdominal aortic aneurysm screening for people who smoke or who have smoked

Alcohol abuse screenings and counseling

Aspirin use in men and women

Blood pressure screenings in adults

Cholesterol screenings for adults in certain age ranges or at high risk

Colorectal cancer screenings for men and women over 50

Depression screenings in adults

Diet counseling for those who are at high risk for chronic conditions

HIV screenings for adults at high risk

Immunizations for adults:

Hepatitis A

Hepatitis B

Herpes Zoster

Human Papillomavirus (HPV)

Influenza (Flu)

Measles, Mumps, Rubella (MMR)

Meningococcal

Pneumococcal

Tetanus, Diphtheria, Pertussis

Varicella

Obesity screenings and counseling

STI (sexually transmitted infections) prevention counseling

Syphilis screenings

4 Reasons why Your Health Insurance is not the same as Healthcare

Think about your health insurance for a moment. Would you be able to tell me exactly where your insurance ends and your actual healthcare begins? Believe it or not (and you may be a part of this group,) most Americans don’t really understand the difference between healthcare and health insurance. Most people would group them together and assume that it’s all part of one big package. Let’s take a look at why the two can be confusingly intertwined: 

  1. Most National Initiatives Encourage Increased Coverage – We’re looking at you Affordable Care Act. When the healthcare conversation starts, it goes immediately to the amount of covered Americans and the affordability of the coverage.  See what we did there? We aren’t talking about where people get care or how much they pay for care. We’re talking about how much we pay for coverage. Very different. 
  1. Insurance Companies Have Contracts with Providers – This is called your “network” (even PPO) of doctors that you’re able to see on your plan. Sure, they aren’t owned by the provider (mostly), but they do work hand in hand. When thinking of your doctor, you’re forced to think about your insurance. 
  1. 20% of Economic Spending goes to Healthcare – why does this matter? Because what the consumer sees is simply the point of sale, and it happens primarily at 2 intervals: 1 being your bill from your doctor, and 2 being your monthly paycheck deduction for health coverage (interesting take on that here). 
  1. It’s not a True Insurance – Think about the things that you insure for yourself. Your car, your home. These are things that are covered in the unlikely event that they were to be destroyed in a fire. Your health insurance runs the gamut of your care. Each piece of the pie is covered (to some degree), leaving you with more of a payment plan. 

With these thoughts in mind, it’s important to consider that without understanding the degree of separation that happens between health care and health coverage. I’m a huge proponent of turning people into educated healthcare consumers. This means shopping around for your healthcare like you would for any other commodity. In order to do this, especially on a large scale (say, larger than you and your significant other,) you have to make people understand that your healthcare is not your health insurance. 

So if you’re reading this for yourself, just understand that your doctor and your insurance plan aren’t part of the same organization. If you’re reading this because you’re in charge of a company health plan – you should help your employees understand this differentiation. Ask them about their doctor, and who they work with, explain to them that their “network” is an arrangement with your insurance firm, and not a direct company affiliate.

3 Reasons Why You Should be Engaged in Your Healthcare

Believe it or not, one of our biggest hurdles in making impactful change is getting people to understand why they should care about their healthcare and about their care process. Realistically, we know what our goals are: save money and get better care. This is the case for both those paying for (employers and individuals) and those receiving (the patients) the care. The issue at hand is this: most people don’t want to engage. And you know what? That’s ok, and it’s not their fault. Healthcare is complicated and, frankly, not designed with the user in mind. And we shouldn’t feel unprepared just because we aren’t a doctor ourselves.

Let’s look at a few things that can happen if you choose not to engage in your care process:

1.       Being treated for the wrong illness – believe it or not this happens more than you’d think. Doctor’s use their god given powers of deduction to make their best, most educated guess as to what’s going on with you. Most people have been through the process of going back and forth with their doctors trying to diagnose whether you’ve got a flu or if its something different. Now imagine if you’ve got a more serious condition, say Cancer. Imagine going through treatments just to realize that you’ve got something else…

2.       Taking the wrong medication – we all know what kinds of side effects each medication has. If you’ve got a wrong diagnosis, chances are you’re taking medication that is meant to fix something that isn’t wrong with you. This could have serious implications.

3.       Having a “never event” – These are defined as “serious medical errors or adverse events that should never happen to a patient. Consequences include both patient harm and increased cost to the institution” and definitely include wrong surgeries.  It might seem like a slim chance that this could happen, but a little bit of engagement from the patient’s end can have seriously positive implications.

Why is this all important? For two reasons:

1.       It costs money – simply put, the easiest way to reduce medical costs is to get the correct care every time. The more errors, the more money.

2.       It hurts – who likes surgery? Heck, who likes the dentist? Nobody wants to go within a mile of a drill or scalpel if they don’t absolutely have to. Getting incorrect care means more procedures, whether they fix you or not.

3.       You’re still not getting any better – if you’re getting the wrong care, it means that you’ve been missing out on the correct care

 

At the end of the day, it’s up to you to make the decision to engage with your doctor. And if you’re responsible for running an effective benefits plan and need somewhere to start, you can check out this link.

The Value of a Second Opinion

If I could tell you one thing, and one thing only to make your healthcare experience better [cheaper], it would be this – when it comes to medical treatments, be sure. I could end the article there, but I’m long winded.

I’d be willing to bet that if you took your car into the shop and the mechanic told you that he had to replace your transmission for $5,000 you’d go and get 5 quotes from any mechanic you can find. But when it comes to our bodies we do no such thing. Perhaps it’s our desire to get better at all costs, perhaps it’s that we’re more comfortable blindly trusting our doctors and believing that they (and only they) know what is truly best. We all have to sleep at night, after all.

Think about a typical diagnosis at your doctor’s office – you go in, they see you, they provide answers and administer treatments. Isn’t it odd that they always know what’s wrong? I mean, how is that possible? Its not.  Your doctor doesn’t always know what’s wrong with you. Now, I don’t want to be accusatory or give the impression that I don’t believe in doctors, so I’m going to let this Mayo Clinic study do the talking. In short, they found that 88% of people had a diagnosis change when they sought another opinion.

The study found that:

  • 21% of individuals had a completely new diagnosis – this means that patients would have pursued the wrong treatment, paid for it, and had to suffer the medical consequences. Imagine if their treatment had involved removing an organ or two. Or if they had to go through chemotherapy only to find out that they didn’t have cancer.
  • 66% of people had to refine their diagnosis – ok, so at least we’re in the ballpark for the diagnosis is. But even if we’re close, that doesn’t mean its right, and when you’ve got surgeries or heavy treatments involved, you’ve got to be right.

88% needed some kind of adjusting – even a minor adjustment to your diagnosis has large implications. Consider this – if you’re actively treating the wrong disease, your correct disease is still going untreated. That means that you’ll have increased symptoms to treat when you do finally get it right.

Dr. Naessens (the research lead) says that primary care providers may be a touch overconfident when giving a diagnosis – “This may prevent identification of diagnostic error, and could lead treatment delays, complications leading to more costly treatments, or even patient harm or death”. That’s pretty serious.

There are a few things that you can do to help to mitigate this risk.

  1. Ask for a referral – you can get a second opinion from a specialist if you’re seeing your GP or primary care physician, they can point you in the right direction. Dr. Naessens warns that lots of people may not feel comfortable asking for this opinion.
  2. Go to a second opinion service. There are a multitude of these available. They’ll look at your current records and any files associated with the treatment to determine if they agree with your doctor. Its nice to have a second set of eyes checking everything over. These guys are usually pretty fast and you don’t even have to see another doctor.

 

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5 facts about healthcare literacy I bet you didn’t know

Think about the last time that you read something (whoa, how cool is that, you’re reading something right now!), and think about how valuable that skill is. Without it you wouldn’t be able to keep up with the news, do your job or even send a text message. Now consider that most people aren’t what we call “health literate”.

–> Health literacy is really all about being able to properly communicate with your doctor, understand what your doctor is telling you, and make an informed decision (or even follow directions) – don’t trust me, trust the CDC.

Now, before you discount this gibberish and “somebody else’s problem”, check out these stats…

 

 

  • Who’s HIGHLY Health Literate?

 

Let’s start with the crème de la crème of the population, those with very high health literacy rates. How many of us are there? About 12% of the population. That’s ok, right? Not really. This is the group of people  that is deemed capable enough to calculate their insurance premiums for the year and be able to maintain a good standard of health. Only 12% of people can do this. Scary, huh?

 

 

  • Who has a “below basic” level of literacy?

 

14% of the population. Yep, more people are unable to “read a short list of instructions” than are able to feasibly communicate with and find a doctor (the highly literate). This is a seriously low level of capabilities and results in a very poor overall condition of health. With levels of literacy this low, it creates issues for those with chronic conditions being largely unable to manage over a long period of time.

 

 

  • How about the rest of us?

 

Most of us (over 50% in fact) fall into the category of intermediate. This means that we know what medications to take and how often to take them. Pretty minimal stuff, really.  But can we manage the more complex stuff? Can we be reasonably expected to make an informed decision for bigger things like surgeries or procedures? Probably not.

 

 

  • Why should I care?

 

Limited health literacy has been described as an “epidemic” by more than a few researchers. It means that most people will have some difficulty in getting care, and that the care provided may not be very impactful. And to top it off, this “epidemic” impacts a wide cross section of the population, not just the undereducated. In reality, any company is going to have a significant amount of their employees that fall well below “proficient” in their literacy and this translates into big dollars and poor health. For those of you that manage employer health plans, impacting health literacy means better benefits for your employees for less money. That’s something that everybody can get behind.

 

 

  • Is there anything that we can do?

 

Short answer – yes. Long answer – you’ve got to help people get relevant information when they need it. No, your 60 page SPD (that huge document that “explains” your benefits) doesn’t count, you really have to meet people halfway and give them information where they are (on their phones). Technology has come a long way and can help people with things like tracking medications and doing doctors visits over the phone. People want to take their health seriously, we just need to give them the tools to do it.

 

 

Source: health.gov

Health Literacy Level Task Examples Percentage
Proficient Using a table, calculate an employee’s share of health insurance costs for a year. 12%
Intermediate Read instructions on a prescription label, and determine what time a person can take the medication. 53%
Basic Read a pamphlet, and give two reasons a person with no symptoms should be tested for a disease. 21%
Below Basic Read a set of short instructions, and identify what is permissible to drink before a medical test. 14%